• 【操纵和武力作为性胁迫策略: 概念和经验差异。】 复制标题 收藏 收藏
    DOI:10.1002/ab.20200 复制DOI
    作者列表:Lyndon AE,White JW,Kadlec KM
    BACKGROUND & AIMS: :This study examines the relationship between perpetrator characteristics, situational characteristics, and type of sexual coercion tactics used to obtain sexual contact (including sexual intercourse) with an unwilling partner. Men who used manipulation or force were compared to each other and to men who engaged in only consensual sex. Participants were college men drawn from the first wave of a 5-year longitudinal study. Stepwise discriminant function analyses, univariate analyses of variance (ANOVA), and chi(2) analyses tested group differences. As predicted, men who used force reported more childhood sexual abuse, witnessed more domestic violence, were more accepting of male violence, and were less likely to endorse love as a motive for sex than men in both the manipulation and consent groups. Men in the force group were also more likely to have had a casual relationship with the woman, and to be drinking and also intoxicated during the coercive incident than men in the manipulation group. Hypothesized differences between men who used force and manipulation regarding parental physical punishment, traditional gender role attitudes, delinquency, hedonistic and dominance motives for sex, prior sexual contact, and the length of the relationship were not supported. The results suggest that types of tactic used in sexual assaults can be distinguished on the basis of person and situational variables and that knowledge of these differences can facilitate future research, as well as rape deterrent and intervention programs.
    背景与目标: : 这项研究研究了犯罪者特征,情境特征和用于与不愿意的伴侣进行性接触 (包括性交) 的性胁迫策略类型之间的关系。将使用操纵或武力的男人彼此比较,并将其与仅进行自愿性行为的男人进行比较。参与者是从为期5年的纵向研究的第一波中抽取的大学生。逐步判别函数分析,单变量方差分析 (ANOVA) 和chi(2) 分析测试了组差异。正如预期的那样,在操纵和同意组中,使用武力的男人报告了更多的童年性虐待,目睹了更多的家庭暴力,更接受男性暴力,并且不太可能将爱情作为性动机。与操纵组中的男人相比,在强迫事件中,武力组中的男人与女人有随意的关系,喝酒和陶醉的可能性也更高。假设在父母的身体惩罚,传统的性别角色态度,犯罪,享乐主义和性支配动机,先前的性接触以及关系的长短方面使用武力和操纵的男性之间存在差异。结果表明,可以根据个人和情况变量来区分性侵犯中使用的策略类型,并且对这些差异的了解可以促进未来的研究以及强奸威慑和干预计划。
  • 【因饮食失调而住院的患者的感知胁迫和感知入院需求的变化。】 复制标题 收藏 收藏
    DOI:10.1176/ajp.2007.164.1.108 复制DOI
    作者列表:Guarda AS,Pinto AM,Coughlin JW,Hussain S,Haug NA,Heinberg LJ
    BACKGROUND & AIMS: OBJECTIVE:Ambivalence toward treatment is characteristic of eating disorders, and patients are often admitted to inpatient programs under pressure from clinicians, family, friends, educators, or employers. This study evaluated patient perceptions of the admissions process and perceived need for hospitalization and assessed whether these perceptions remain stable in the short term. METHOD:A total of 139 patients with eating disorders completed a 13-item self-report scale on the admission experience when they were admitted to a behavioral inpatient specialty program and again 2 weeks into their hospitalization. RESULTS:Patients with anorexia nervosa reported higher levels of perceived coercion and pressure and a lower sense of procedural justice than did those with bulimia. Patients under 18 (N=35) reported more perceived coercion than did adult patients (N=104), and a trend was noted for them to disagree that they needed hospitalization. Perceptions of coercion, of pressure by others toward hospitalization, and of procedural justice were stable in the short term. However, of the 46 patients (30 of them adults) who initially did not endorse needing admission, 20 patients (17 of them adults) changed their minds by 2 weeks into hospitalization and agreed that they needed hospital admission. CONCLUSIONS:Nearly half of patients with eating disorders who denied a need for treatment on admission converted to acknowledging that they needed to be admitted within 2 weeks of hospitalization. Since treatment avoidance is associated with poor outcome, these findings suggest a need for studies assessing the long-term outcome and ethics of pressuring patients with eating disorders into treatment.
    背景与目标:
  • 【精神病患者在入院过程中对胁迫的感知的事实来源。】 复制标题 收藏 收藏
    DOI:10.1176/ajp.155.9.1254 复制DOI
    作者列表:Lidz CW,Mulvey EP,Hoge SK,Kirsch BL,Monahan J,Eisenberg M,Gardner W,Roth LH
    BACKGROUND & AIMS: OBJECTIVE:The purpose of this study was to determine what predicts patients' perceptions of coercion surrounding admission to a psychiatric hospital.

    METHOD:For 171 cases, the authors integrated data from interviews with patients, admitting clinicians, and other individuals involved in the patients' psychiatric admissions with data from the medical records. Using a structured set of procedures, coders determined whether or not nine coercion-related behaviors occurred around the time of admission. Correlation and regression analyses were used to describe the predictors of patients' scores on the MacArthur Perceived Coercion Scale.

    RESULTS:The use of legal force, being given orders, threats, and "a show of force" were all strongly correlated with perceived coercion. A least squares regression accounted for 43.3% of the variance in perceived coercion. The evidence also suggested that force is typically only used in conjunction with less coercive pressures.

    CONCLUSIONS:Force and negative symbolic pressures, such as threats and giving orders about admission decisions, induce perceptions of coercion in persons with mental illness. Positive symbolic pressures, such as persuasion, do not induce perceptions of coercion. Such positive pressures should be tried in order to encourage admission before force or negative pressures are used.

    背景与目标: 目的 : 本研究的目的是确定什么预测了患者对精神病院住院的强迫观念。
    方法 : 对于171例,作者整合了来自患者访谈的数据,接受临床医生和其他参与患者精神科入院的个人的医疗记录数据。编码人员使用一组结构化的程序,确定在入院前后是否发生了九种与胁迫相关的行为。相关和回归分析用于描述麦克阿瑟感知胁迫量表上患者得分的预测因子。
    结果 : 使用法律武力,被命令,威胁,“武力表现” 都与感知到的胁迫密切相关。最小二乘回归解释了感知胁迫的43.3% 方差。证据还表明,武力通常仅与较小的胁迫压力一起使用。
    结论 : 武力和负面的象征性压力,例如威胁和下达有关入院决定的命令,会引起对精神疾病患者的胁迫感。积极的象征性压力,例如说服,不会引起人们对胁迫的看法。在使用力或负压之前,应尝试使用这种正压以鼓励进入。
  • 【补体胁迫的电生理相关性。】 复制标题 收藏 收藏
    DOI:10.1162/jocn.2009.21333 复制DOI
    作者列表:Kuperberg GR,Choi A,Cohn N,Paczynski M,Jackendoff R
    BACKGROUND & AIMS: :This study examined the electrophysiological correlates of complement coercion. ERPs were measured as participants read and made acceptability judgments about plausible coerced sentences, plausible noncoerced sentences, and highly implausible animacy-violated sentences ("The journalist began/wrote/astonished the article before his coffee break"). Relative to noncoerced complement nouns, the coerced nouns evoked an N400 effect. This effect was not modulated by the number of possible activities implied by the coerced nouns (e.g., began reading the article; began writing the article) and did not differ either in magnitude or scalp distribution from the N400 effect evoked by the animacy-violated complement nouns. We suggest that the N400 modulation to both coerced and animacy-violated complement nouns reflected different types of mismatches between the semantic restrictions of the verb and the semantic properties of the incoming complement noun. This is consistent with models holding that a verb's semantic argument structure is represented and stored at a distinct level from its syntactic argument structure. Unlike the coerced complement noun, the animacy-violated nouns also evoked a robust P600 effect, which may have been triggered by the judgments of the highly implausible (syntactically determined) meanings of the animacy-violated propositions. No additional ERP effects were seen in the coerced sentences until the sentence-final word that, relative to sentence-final words in the noncoerced sentences, evoked a sustained anteriorly distributed positivity. We suggest that this effect reflected delayed attempts to retrieve the specific event(s) implied by coerced complement nouns.
    背景与目标: : 这项研究检查了补体胁迫的电生理相关性。当参与者阅读并对合理的胁迫句子,合理的非胁迫句子以及高度令人难以置信的违反动画的句子做出可接受性判断时,对erp进行了衡量 (“记者在喝咖啡休息前开始/写/惊讶了这篇文章”)。相对于非强制补语名词,强制名词引起N400效应。这种效果不受强制名词所暗示的可能活动的数量的调节 (例如,开始阅读文章; 开始撰写文章),并且在幅度或头皮分布上与动画引起的N400效果没有差异-违反补体名词。我们建议,对强制和违反动画的补语名词的N400调制反映了动词的语义限制与传入补语名词的语义属性之间的不同类型的不匹配。这与模型一致,该模型认为动词的语义参数结构在与句法参数结构不同的层次上表示和存储。与强制补语名词不同,违反动画的名词还引起了强大的P600效果,这可能是由违反动画的命题的高度不可信 (语法确定) 含义的判断触发的。在强迫句子中没有看到其他ERP效果,直到句子-最后一个单词相对于非强迫句子中的句子-最后一个单词引起了持续的前向分布的积极性。我们建议这种效果反映了延迟尝试检索强制补语所隐含的特定事件的尝试。
  • 5 Subtle coercion in psychiatric practice. 复制标题 收藏 收藏

    【精神病实践中的微妙胁迫。】 复制标题 收藏 收藏
    DOI:10.1046/j.1365-2850.1998.00104.x 复制DOI
    作者列表:Lützén K
    BACKGROUND & AIMS: Making nursing decision for patients who cannot communicate their own wishes and needs is a common problem in psychiatric and mental health nursing. The aim of this article is to present the findings of a qualitative study focused on situations in which patients do not cooperate with a nursing decision about what should be done for them. The design of the study utilized some steps associated with the grounded theory method. Data were collected from unstructured interviews with 10 British nurses with long experience in psychiatric nursing. By implementing the strategy of constant comparative analysis of the transcribed interviews, it was found that nurses use different types of subtle coercion in order to achieve their own goals for the patient. These goals were justified as being in the best interest of the patient. The main components of subtle coercion are part of a process consisting ofassessing a patient's competency for self-choice; acting strategically; modifying the principle af autonomy; justifying strategies; and reflecting ethically on the action taken. The study indicates that further empirical investigation of clinical situations involving subtle coercion is required. Particular attention should be paid to organizational factors and how these contribute to the use of subtle coercion.

    背景与目标: 为无法传达自己的意愿和需求的患者做出护理决策是精神科和精神卫生护理中的常见问题。本文的目的是介绍一项定性研究的结果,该研究侧重于患者不配合护理决定应为他们做些什么的情况。研究的设计利用了与扎根理论方法相关的一些步骤。数据是从对10名在精神病护理方面具有长期经验的英国护士的非结构化访谈中收集的。通过实施对转录访谈进行持续比较分析的策略,发现护士使用不同类型的微妙胁迫来实现患者自己的目标。这些目标被认为符合患者的最大利益。微妙胁迫的主要组成部分是评估患者自我选择能力的过程的一部分; 战略行动; 修改自主原则; 合理的策略; 并从道德上反映所采取的行动。研究表明,需要对涉及微妙胁迫的临床情况进行进一步的实证研究。应特别注意组织因素以及这些因素如何有助于使用微妙的胁迫。
  • 【蚂蚁物种幼虫发育的社会胁迫。】 复制标题 收藏 收藏
    DOI:10.1007/s00114-016-1341-8 复制DOI
    作者列表:Villalta I,Amor F,Cerdá X,Boulay R
    BACKGROUND & AIMS: :Ants provide one of the best examples of the division of labor in animal societies. While the queens reproduce, workers generally refrain from laying eggs and dedicate themselves exclusively to domestic tasks. In many species, the small diploid larvae are bipotent and can develop either into workers or queens depending mostly on environmental cues. This generates a conflicting situation between the adults that tend to rear a majority of larvae into workers and the larvae whose individual interest may be to develop into reproductive queens. We tested the social regulation of larval caste fate in the fission-performing ant Aphaenogaster senilis. We first observed interactions between resident workers and queen- and worker-destined larvae in presence/absence of the queen. The results show that workers tend to specifically eliminate queen-destined larvae when the queen is present but not when she is absent or imprisoned in a small cage allowing for volatile pheromone exchanges. In addition, we found that the presence of already developed queen-destined larvae does not inhibit the development of younger still bipotent larvae into queens. Finally, we analyzed the cuticular hydrocarbon profiles of queen- and worker-destined larvae and found no significant quantitative or qualitative difference. Interestingly, the total amount of hydrocarbons on both larval castes is extremely low, which lends credence on the chemical insignificance hypothesis of larval ants. Overall, our results suggest that workers control larval development and police larvae that would develop into queens instead of workers. Such policing behavior is similar in many aspects to what is known of worker policing among adults.
    背景与目标: : 蚂蚁提供了动物社会分工的最好例子之一。在皇后繁殖的同时,工人通常不产卵,而专门从事家务。在许多物种中,小二倍体幼虫是双能的,主要取决于环境线索,它们可以发育成工人或皇后。这在成虫之间产生了矛盾的局面,成虫倾向于将大部分幼虫抚养成工人,而幼虫的个人兴趣可能是发展成为生殖皇后。我们在裂变性能的蚂蚁Aphaenogaster senilis中测试了幼虫种姓命运的社会调节。我们首先观察到在存在/不存在女王的情况下,常驻工人与女王和工人指定的幼虫之间的相互作用。结果表明,当女王存在时,工人倾向于专门消除女王指定的幼虫,但当她不在或被囚禁在一个小笼子中,以便进行挥发性信息素交换时,则不会。此外,我们发现已经发育的皇后幼虫的存在不会抑制年轻的仍然是双能幼虫向皇后的发育。最后,我们分析了女王和工人指定的幼虫的表皮碳氢化合物分布,没有发现明显的定量或定性差异。有趣的是,两种幼虫种姓上的碳氢化合物总量都非常低,这为幼虫蚂蚁的化学无意义假说提供了依据。总体而言,我们的结果表明,工人控制幼虫的发育,而警用幼虫会发育成皇后而不是工人。这种警务行为在许多方面与成年人中工人警务的已知相似。
  • 【开放: 精神科护士参加以强制使用为重点的反思小组的经历。】 复制标题 收藏 收藏
    DOI:10.1111/j.1365-2850.2005.00827.x 复制DOI
    作者列表:Olofsson B
    BACKGROUND & AIMS: :Psychiatric staff report that the use of coercion towards patients in psychiatric care engenders feelings of discomfort and conflicts. The aim of this study was to describe psychiatric nurses' experiences of participating in reflection groups focused on the use of coercion, in relation to their views regarding systematic clinical supervision and staff support. Twenty-one nurses who had participated in reflection groups were interviewed retrospectively. The structured interview focused on: (i) their views of clinical supervision and support in general; (ii) their views of clinical supervision and support specifically concerning the use of coercion; and (iii) their experiences of participating in groups reflecting the use of coercion. Nurses were largely positive about participating in reflection groups, as expressed in the subthemes: having time for reflection; being confirmed; gaining new perspectives; sharing fellowship with colleagues; and relating more effectively to patients. Complications concerning participation in the reflection groups and other forms of clinical supervision as reported by nurses were: providing time for participation; having a common aim; being vulnerable in difficult situations; and assuming that the need for supervision and support could indicate that they were not coping with their job.
    背景与目标: : 精神科工作人员报告说,在精神科护理中对患者使用胁迫会引起不适和冲突的感觉。这项研究的目的是描述精神科护士参加针对强迫使用的反思小组的经历,以及他们对系统的临床监督和人员支持的看法。回顾性采访了参加反思小组的21名护士。结构化访谈的重点是 :( i) 他们对临床监督和总体支持的看法; (ii) 他们对临床监督和支持的看法,特别是关于强制使用的意见; (iii) 他们参加反映强制使用的小组的经验。正如子主题所表达的那样,护士对参加反思小组持积极态度: 有时间反思; 被确认; 获得新观点; 与同事分享奖学金; 并更有效地与患者联系。护士报告的参与反思小组和其他形式的临床监督的并发症是: 提供参与时间; 有共同的目标; 在困难的情况下脆弱; 并假设需要监督和支持可能表明他们没有应付自己的工作。
  • 【补体胁迫不受竞争的调节: 来自眼球运动的证据。】 复制标题 收藏 收藏
    DOI:10.1037/0278-7393.34.1.1 复制DOI
    作者列表:Frisson S,McElree B
    BACKGROUND & AIMS: :An eye-movement study examined the processing of expressions requiring complement coercion (J. Pustejovsky, 1995), in which a noun phrase that does not denote an event (e.g., the book) appears as the complement of an event-selecting verb (e.g., began the book). Previous studies demonstrated that these expressions are more costly to process than are control expressions that can be processed with basic compositional operations (L. Pylkkanen & B. McElree, 2006). Complement coercion is thought to be costly because comprehenders need to construct an event sense of the complement to satisfy the semantic restrictions of the verb (e.g., began writing the book). The reported experiment tests the alternative hypotheses that the cost arises from the need to select 1 interpretation from several or from competition between alternative interpretations. Expressions with weakly constrained interpretations (no dominant interpretation and several alternative interpretations) were not more costly to process than expressions with a strongly constrained interpretation (1 dominant interpretation and few alternative interpretations). These results are consistent with the hypothesis that the cost reflects the on-line construction of an event sense for the complement.
    背景与目标: : 一项眼动研究检查了需要补语强制的表达的处理 (J. Pustejovsky,1995),其中不表示事件的名词短语 (例如,书) 显示为事件选择动词的补语 (例如,开始了这本书)。先前的研究表明,这些表达式比可以用基本组成操作处理的控制表达式更昂贵 (L. Pylkkanen & B. McElree,2006)。补语强制被认为是昂贵的,因为理解者需要构造补语的事件感以满足动词的语义限制 (例如,开始写书)。报告的实验测试了替代假设,即成本来自需要从几种解释中选择一种解释或来自替代解释之间的竞争。具有弱约束解释的表达 (没有主要解释和几种替代解释) 与具有强约束解释的表达 (1种主要解释和很少的替代解释) 相比,处理成本更高。这些结果与以下假设一致: 成本反映了事件意义的在线构建。
  • 【开发和初步验证一种工具,以衡量感知到的强迫进入药物滥用治疗的手段。】 复制标题 收藏 收藏
    DOI:10.1037/0893-164X.20.4.463 复制DOI
    作者列表:Klag S,Creed P,O'Callaghan F
    BACKGROUND & AIMS: :The present study involved 3 phases that led to the development and initial validation of the Perceived Coercion Questionnaire (PCQ), a scale that researchers use to measure perceptions of coercion of drug and alcohol users to enter drug and alcohol treatment. In Phase 1, the authors used focus groups to generate 48 pilot items. In Phase 2, the items were administered to a sample of 158 drug and alcohol users who were in residential treatment within a therapeutic community setting. Item and exploratory factor analyses reduced the number of items to 32, which represented 6 homogeneous and internally reliable subscales. In Phase 3, the PCQ was administered to a second sample of 362 drug and alcohol users. Confirmatory factor analysis led to a final scale of 30 items across 6 subscales that demonstrated sound consistency and validity. Implications for research and practice are highlighted.
    背景与目标: : 本研究涉及三个阶段,这些阶段导致了感知胁迫问卷 (PCQ) 的开发和初步验证,研究人员使用该量表来衡量吸毒者和酗酒者进入毒品和酒精治疗的胁迫感知。在第一阶段,作者使用焦点小组生成了48个试点项目。在第2阶段中,将这些物品施用于在治疗社区环境中进行住院治疗的158药物和酒精使用者的样本。项目和探索性因素分析将项目数量减少到32个,代表了6个同质且内部可靠的子量表。在阶段3中,将PCQ施用于362药物和酒精使用者的第二个样本。验证性因素分析得出了6个子量表中30个项目的最终量表,这些量表显示出合理的一致性和有效性。强调了对研究和实践的影响。
  • 【伴侣性胁迫倾向的个体差异。】 复制标题 收藏 收藏
    DOI:10.1177/1079063208327237 复制DOI
    作者列表:Camilleri JA,Quinsey VL
    BACKGROUND & AIMS: :Lalumière, Harris, Quinsey, and Rice (2005) proposed a three-path model (psychopathy, young male syndrome, and competitive disadvantage) of the development of sexually coercive behavior, but none of these individual difference characteristics have been tested among partner rapists. Using a community sample in Study 1, the authors find that psychopathy is the only significant predictor of self-reported propensity for partner sexual coercion. This model is tested in Study 2 by comparing convicted partner rapists, nonsexual partner assaulters, and heterosexual child molesters. One third of partner rapists are psychopaths, and their psychopathy scores are no different from those found in correctional samples. Partner rapists have an average IQ, providing further evidence that competitive disadvantage is less characteristic of partner rapists. There is some indication that partner rapists desist with age. The authors discuss these findings in light of recent findings that implicate cuckoldry risk in partner sexual assault.
    背景与目标: : laumi è re,Harris,Quinsey和Rice (2005) 提出了性胁迫行为发展的三路径模型 (精神病,年轻男性综合症和竞争劣势),但这些个体差异特征均未在伴侣强奸犯中进行测试。使用研究1中的社区样本,作者发现精神病是自我报告的伴侣性胁迫倾向的唯一重要预测指标。在研究2中,通过比较被定罪的伴侣强奸犯,非性伴侣袭击者和异性恋儿童mole亵者,对该模型进行了测试。伴侣强奸犯中有三分之一是精神病患者,他们的精神病评分与矫正样本中的评分没有什么不同。伴侣强奸犯的智商平均,这进一步证明了竞争劣势是伴侣强奸犯的特征。有迹象表明,伴侣强奸犯会随着年龄的增长而停止。作者根据最近的发现讨论了这些发现,这些发现暗示了伴侣性侵犯中的绿帽子风险。
  • 【强迫在成瘾治疗中的应用: 临床方面。】 复制标题 收藏 收藏
    DOI:10.1080/10550490701756369 复制DOI
    作者列表:Sullivan MA,Birkmayer F,Boyarsky BK,Frances RJ,Fromson JA,Galanter M,Levin FR,Lewis C,Nace EP,Suchinsky RT,Tamerin JS,Tolliver B,Westermeyer J
    BACKGROUND & AIMS: :Coerced or involuntary treatment comprises an integral, often positive component of treatment for addictive disorders. By the same token, coercion in health care raises numerous ethical, clinical, legal, political, cultural, and philosophical issues. In order to apply coerced care effectively, health care professionals should appreciate the indications, methods, advantages, and liabilities associated with this important clinical modality. An expert panel, consisting of the Addiction Committee of the Group for the Advancement of Psychiatry, listed the issues to be considered by clinicians in considering coerced treatment. In undertaking this task, they searched the literature using Pubmed from 1985 to 2005 using the following search terms: addiction, alcohol, coercion, compulsory, involuntary, substance, and treatment. In addition, they utilized relevant literature from published reports. In the treatment of addictions, coercive techniques can be effective and may be warranted in some circumstances. Various dimensions of coercive treatment are reviewed, including interventions to initiate treatment; contingency contracting and urine testing in the context of psychotherapy; and pharmacological methods of coercion such as disulfiram, naltrexone, and the use of a cocaine vaccine. The philosophical, historical, and societal aspects of coerced treatment are considered.
    背景与目标: : 强迫或非自愿治疗包括成瘾性疾病治疗的一个不可或缺的,通常是积极的组成部分。同样,医疗保健中的胁迫引发了许多道德,临床,法律,政治,文化和哲学问题。为了有效地应用强制护理,医疗保健专业人员应了解与这种重要临床方式相关的适应症,方法,优势和责任。由精神病学促进小组成瘾委员会组成的专家小组列出了临床医生在考虑强制治疗时应考虑的问题。在执行此任务时,他们使用Pubmed 1985年2005年使用以下搜索词搜索文献: 成瘾,酒精,胁迫,强制性,非自愿,物质和治疗。此外,他们还利用了已发表报告中的相关文献。在治疗成瘾时,强制技术可能是有效的,并且在某些情况下可能是必要的。审查了胁迫治疗的各个方面,包括启动治疗的干预措施; 心理治疗背景下的应急合同和尿液测试; 以及胁迫的药理学方法,例如双硫仑,纳曲酮和可卡因疫苗的使用。考虑了强迫治疗的哲学,历史和社会方面。
  • 【胁迫对服务的影响从精神卫生照顾患有共同发生疾病的消费者的角度来看。】 复制标题 收藏 收藏
    DOI:10.1176/ps.2009.60.2.183 复制DOI
    作者列表:Stanhope V,Marcus S,Solomon P
    BACKGROUND & AIMS: OBJECTIVE:Disengagement from services by people with serious mental illnesses continues to be a major challenge for the mental health system. Assertive community treatment combined with Housing First services is an intervention targeted toward consumers whom the system has failed to engage. The processes involved in engaging and maintaining consumers in mental health services play an important role but remain an understudied aspect of the intervention. This study examined the social interaction between consumers and case managers from the perspective of consumers. METHODS:Seventy service contacts between unique consumer-case manager dyads were sampled. Consumers with co-occurring serious mental illness and substance use disorders completed interviews after each service contact. They provided information on sociodemographic characteristics, service contact characteristics, consumer-provider relationship, utilization of coercive strategies, perceived coercion, and service contact evaluation. Multivariate regression analyses examined the association of consumer-provider relationship and perceived coercion with service contact evaluation. RESULTS:Consumer-provider relationship was negatively associated with perceived coercion (effect size=.08). Perceived coercion was negatively associated with service contact evaluation (effect size=.34). Perceived coercion was positively associated with time in the program (effect size=.17) and negatively associated with length of the service contact (effect size=.14). Effect sizes ranging from .08 to .34 are typically considered small to medium. CONCLUSIONS:Findings demonstrate that for consumers, a positive response to service contacts indicated that they did not feel coerced. With consumers whose connection to services is tenuous, an immediate positive response to service contacts may be vital to maintain engagement. Research is needed to identify supportive case manager strategies that facilitate relationship building.
    背景与目标:
  • 【在普通精神病病房中使用抗精神病药和苯二氮卓类药物,以最大程度地减少胁迫和机械约束。】 复制标题 收藏 收藏
    DOI:10.1177/0020764018760650 复制DOI
    作者列表:Højlund M,Høgh L,Bojesen AB,Munk-Jørgensen P,Stenager E
    BACKGROUND & AIMS: BACKGROUND:Decrease in coercive measures can lead to increased exposure to antipsychotics and benzodiazepines. This is not desirable as these drugs are associated with harmful side effects and reduced life expectancy. AIM:To quantify and compare the use of antipsychotic and anxiolytic medications in connection with the implementation of a programme to reduce coercion and restraint. METHODS:Observational study in a general psychiatric ward comparing psychopharmacological treatment after implementation of non-pharmacological interventions to reduce coercion and mechanical restraint with a historical reference cohort from the same ward. RESULTS:Data from 101 admissions after implementation of interventions were compared with data from 85 admissions in a historical reference cohort. Mean defined daily doses of antipsychotics, benzodiazepines or the total amount of both showed no difference before and after implementation of the programme. Standardised regression coefficients (β) from a mixed effects linear regression model, adjusted for age, gender, length of admission, involuntary admission and history of substance abuse showed that neither total dose of antipsychotics (adjusted β: .05, 95% confidence interval (CI): -0.20 to 0.31), total dose of benzodiazepines (adjusted β: -.13, 95%CI: -.42 to 0.16) nor total amount of both drugs (adjusted β: .00, 95%CI: -.26 to 0.21) increased after implementation. CONCLUSION:Decrease in coercive measures from 2013 to 2016 has not lead to significant increases in the use of antipsychotic medication or benzodiazepines. The interventions are useful in establishing restraint-free wards, and careful monitoring of the psychopharmacological treatment is important for patient safety.
    背景与目标:
  • 【理解家庭冲突的路径建模方法: 父母胁迫和青少年回避的相互模式。】 复制标题 收藏 收藏
    DOI:10.1037/a0036817 复制DOI
    作者列表:Saxbe DE,Ramos MR,Timmons AC,Rodriguez AR,Margolin G
    BACKGROUND & AIMS: :Conflict between parents and adolescents involves reciprocal exchanges in which family members influence and shape each other's behavior. This study uses multilevel path analysis to examine interrelations in observed behavior during 15-min conflict discussions conducted by 103 family triads, looking specifically at parent coercive and youth avoidant behaviors. We also explore the moderating roles of parents' past aggressive family conflict behavior on parents' responses to youth behavior. Discussions were coded in 3-min segments. Analyses used time-lagged codes so that a family member's behavior in 1 segment predicted another family member's behavior in the following segment. The fully saturated cross-lagged model tested all possible paths (parents' behavior predicting parents' and youths' subsequent behavior, and vice versa). Parents' coercive behavior was associated with more avoidant youth behavior in the following segment when controlling for youths' prior avoidant behavior. The opposite direction of effects also emerged: Mothers became more coercive when youth were more avoidant in a prior segment. Fathers' coercive behavior was not associated with youths' prior behavior and, with both parents in the same model, father and youth behavior were no longer associated; however, fathers' coercive behavior predicted more mother coercive behavior in the following segment. Mothers who had behaved more aggressively during family conflict over 2 waves of data collection became more coercive when youths were more avoidant, although parents' history of aggressive family conflict behavior did not moderate father-to-youth or youth-to-parent paths.
    背景与目标: : 父母与青少年之间的冲突涉及相互交流,在这种交流中,家庭成员相互影响和塑造彼此的行为。本研究使用多层次路径分析来检查在103家庭三合会进行的15分钟冲突讨论中观察到的行为之间的相互关系,专门研究父母的强迫行为和青年回避行为。我们还探讨了父母过去的侵略性家庭冲突行为对父母对青年行为的反应的调节作用。讨论以3分钟的片段编码。分析使用了时滞代码,以便一个家庭成员在1个片段中的行为预测下一个片段中的另一个家庭成员的行为。完全饱和的交叉滞后模型测试了所有可能的路径 (父母的行为预测父母和年轻人的后续行为,反之亦然)。在控制青少年先前的回避行为时,以下部分中父母的强迫行为与更多的回避青年行为有关。效果的相反方向也出现了: 当年轻人在前一段时间里更回避时,母亲变得更有强制性。父亲的强迫行为与年轻人的先前行为无关,并且在同一模型中,父母双方的父亲和青年行为不再相关; 但是,父亲的强迫行为在以下部分中预测了更多的母亲强迫行为。尽管父母的侵略性家庭冲突行为的历史并未缓和父亲对青年或青年对父母的路径,但在两波数据收集过程中,在年轻人更回避时,在家庭冲突中表现得更加积极的母亲变得更具强制性。
  • 【酒精在男性使用胁迫获得无保护性行为中的作用。】 复制标题 收藏 收藏
    DOI:10.1080/10826080902961419 复制DOI
    作者列表:Abbey A,Parkhill MR,Jacques-Tiura AJ,Saenz C
    BACKGROUND & AIMS: :Past sexual victimization has been identified as a predictor of women's sexual risk-taking. In order to develop effective prevention and treatment programs, research is needed that examines perpetrators' characteristics. Thus, the goal of this study was to examine predictors of men's willingness to use coercive strategies to obtain sex without a condom. Male college students (n = 72) completed a survey that assessed past sexual assault perpetration, hostility, past misperception of women's sexual cues, usual alcohol consumption, and usual condom use. One month later, they participated in an alcohol administration study and watched a video about a couple in a consensual sexual situation. Participants were asked to evaluate how justified they would be in using a variety of coercive strategies to make the woman have unprotected sex. In hierarchical multiple regression analyses, there was a significant main effect of past perpetration such that men who had previously committed sexual assault felt more justified using coercive strategies to obtain unprotected sex than did nonperpetrators. Acute alcohol consumption did not have a main effect; however, it interacted with hostility and misperception. Among participants who consumed alcohol prior to watching the video, the greater their preexisting hostility, the more justified they felt in using coercion. Similarly, the more frequently drinkers had misperceived women's sexual intentions in the past, the more justified they felt in using coercion. Based on these findings, several specific suggestions are made for prevention and treatment programs, including targeted communication skills and normative feedback interventions.
    背景与目标: : 过去的性受害被确定为女性性冒险的预测因素。为了制定有效的预防和治疗方案,需要研究犯罪者的特征。因此,这项研究的目的是研究男性是否愿意使用强迫策略在没有避孕套的情况下获得性行为的预测因素。男大学生 (n = 72) 完成了一项调查,评估了过去的性侵犯行为,敌意,过去对女性性暗示的误解,通常的饮酒和通常的安全套使用。一个月后,他们参加了一项酒精管理研究,并观看了一段视频,内容涉及一对夫妇在自愿的性行为中。参与者被要求评估他们在使用各种强制性策略使该妇女发生无保护性行为时的合理性。在分层多元回归分析中,过去的行为具有重大的主要影响,因此以前曾实施过性侵犯的男性比非犯罪者更合理地使用强制策略获得无保护的性行为。急性饮酒没有主要作用; 但是,它与敌意和误解相互作用。在观看视频之前饮酒的参与者中,他们先前存在的敌意越大,他们在使用胁迫时就越有理由。同样,过去饮酒者误解女性的性意图越频繁,她们在使用胁迫时就越有理由。基于这些发现,针对预防和治疗计划提出了一些具体建议,包括针对性的沟通技巧和规范性反馈干预措施。

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